positions as necessary
CHEST PHYSIOTHERAPY:
Percussion or Clapping
Forceful striking of the skin with cupped hands
Can mechanically dislodge tenacious secretions
Steps:
Cover the area with a towel or gown to reduce
discomfort
Ask the client to breathe slowly and deeply to
promote relaxation
Alternately flex and extend the wrists rapidly to
slap the chest
Percuss each affected lung segment for 1-2
minutes
CHEST PHYSIOTHERAPY:
Vibration
Series of vigorous quiverings produced
by hands that are placed against the
client’s chest wall
Used after percussion to increase the
turbulence of the exhaled air
Done alternately with percussion
Steps:
Place hands, palms down, on the chest
area to be drained, one hand over the
other with the fingers together and
extended
CHEST PHYSIOTHERAPY:
Vibration
Ask the client to inhale deeply and exhale
slowly through the nose and pursed lips
During exhalation, tense all the hand and
arm muscles, and using mostly the heel
of the hand, vibrate the hands, moving
them downward. Stop when client inhales
Vibrate during five exhalations over one
affected lung
After each vibration, encourage client to
cough and expectorate secretions
CHEST PHYSIOTHERAPY:
Postural Drainage
The drainage by gravity secretions
from various lung segments
Bronchodilators or nebulization
therapy may be given before
postural drainage
Scheduled 2 or 3 times a day
depending on degree of lung
congestion
Each position is usually assumed
for 10-15 minutes
OXYGEN THERAPY
Prescribed by the physician; but can be
given without order in emergency cases
Physician specifies method of delivery, liter
flow per minute (LPM) and concentration of
oxygen (Fi02: fraction of inspired oxygen)
Indications:
Difficulty ventilating all areas of the lungs
Impaired gas exchange
Heart failure (MI)
Hypoxia/ hypoxemia
Hazards or complications:
Ventilatory depression
Oxygen toxicity (Retrolental Fibroplasia: O2 toxicity
in newborns) this can occur if the Fi02 given is >50%
in a 24hour duration
Bacterial contamination- contaminated humidification
system
Skin irritation from device material
Drying effect on the mucous membranes of
respiratory tract-use humidifiers
Oxygen supply:
Wall outlets
Tanks and cylinders
Portable oxygen cylinders
OXYGEN THERAPY:
Types of O2 delivery systems
Low flow systems: will not meet the entire flow demand of the patient
NASAL CANNULA/ NASAL PRONGS AND NASAL CATHETER
O2 concentration: 24-45% at flow rates 2-6L per minute
Advantages:
most common and inexpensive device
easy to apply
does not interfere with the client’s ability to talk or eat
comfortable and allows freedom of movement
Disadvantages:
inability to deliver higher concentrations of O2
drying and irritating to mucous membranes
can be easily dislodged
SIMPLE FACE MASK
covers the client’s nose and mouth
-40-60% concentration at 5-8L per minute
OXYGEN THERAPY:
Types of O2 delivery systems
NASAL CANNULA SIMPLE FACE
MASK
OXYGEN THERAPY:
Types of O2 delivery systems
Partial rebreather mask
same as non-rebreather mask but without
valves
allows the client to rebreathe about the first
third of the exhaled air (the reservoir bag)
increases the FiO2 by recycling oxygen
O2 concentration of 60-90% at 6-10L per
minute flow
nurse should not let bag be totally deflated; if
this occurs increase the flow rate
OXYGEN THERAPY:
Types of O2 delivery systems
Non-rebreather mask
delivers highest O2 concentration as possible
contains one-way valves which prevents the air
room and client’s expired air from entering the
reservoir bag
only oxygen in the bag is inspired again
should not be totally deflated during inspiration
to prevent CO2 build up; if it occurs increase
flow rate
95-100% concentration at 10-15L per minute
flow
OXYGEN THERAPY:
Types of O2 delivery systems
High flow systems: will meet the entire flow
need of the patients
Venturi mask
has wide bore tubing and color coded jet
adapters
delivers 24-40% or 50% at 4-10L pr minute
flow
color coded adapters:
Blue- 24% Green- 35%
Yellow- 28% Peach- 40%
White-31% Orange- 50%
OXYGEN THERAPY:
Types of O2 delivery systems
VENTURI MASK YELLOW ADAPTER
ADAPTERS ATTACHED TO
35%
28% 31% MASK